{"created":"2023-05-25T05:25:45.745534+00:00","id":4241,"links":{},"metadata":{"_buckets":{"deposit":"1f7ee491-fb57-4e71-be91-0111c9e38dcd"},"_deposit":{"created_by":17,"id":"4241","owners":[17],"pid":{"revision_id":0,"type":"depid","value":"4241"},"status":"published"},"_oai":{"id":"oai:yamagata.repo.nii.ac.jp:00004241","sets":["29:31:124:125"]},"author_link":["13359","13361","13347","13352","13354","13351","13358","13345","13335","13356","13342","13360","13353","13362","13344","13349","13357","13340","13333","13346","13350","13355","13341","13348","13343","13337","13339","13338","13334","13336"],"item_3_alternative_title_18":{"attribute_name":"その他の言語のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Two cases of laparoscopic surgery for ovarian hemorrhage at early pregnant period"}]},"item_3_alternative_title_19":{"attribute_name":"タイトル（ヨミ）","attribute_value_mlt":[{"subitem_alternative_title":"ニンシン ショキ ノ ランソウ シュッケツ ニ タイシテ キンキュウ フククウキョウカ シュジュツ オ オコナッタ 2レイ"}]},"item_3_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2018-02-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"83","bibliographicPageStart":"77","bibliographicVolumeNumber":"36","bibliographic_titles":[{"bibliographic_title":"山形大学紀要. 医学 : 山形医学"},{"bibliographic_title":"Bulletin of the Yamagata University. Medical science : Yamagata medical journal","bibliographic_titleLang":"en"}]}]},"item_3_description_42":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"subitem_description":"論文(Article)","subitem_description_type":"Other"}]},"item_3_description_5":{"attribute_name":"内容記述","attribute_value_mlt":[{"subitem_description":"【緒言】妊娠初期の卵巣出血は、子宮内に胎嚢を認めなかった場合、異所性妊娠との鑑別が困難であり臨床上対応に苦慮する。今回我々は、妊娠初期の卵巣出血にて緊急腹腔鏡下手術が有用であった2例を経験したので報告する。\n【症例】症例１：41歳、6経妊3経産。月経49日目。性交後の右下腹部痛を主訴に近医を受診。妊娠反応陽性で経腟超音波検査にて子宮内に胎嚢を認められず腹腔内出血が疑われたため、異所性妊娠の疑いで、当科へ救急搬送となった。搬送時血中hCG値は609 mIU/mlであった。右子宮付属器の血腫と貧血の進行を認めたため、緊急腹腔鏡下手術を施行した。腹腔内を観察すると、右黄体血腫の破裂部位からの動脈性出血を認めたため同部位を凝固止血した。左右の卵管に異常所見を認めなかった。出血量は約500mlであった。術後、子宮内に胎嚢を認め子宮内妊娠を確認した。\n症例２：31歳、1経妊0経産。月経35日目。右下腹痛にて当院救急外来受診。急性腹症として造影CT検査施行したところ右付属器が腫大し造影効果を認めた。経腟超音波検査にて子宮内に胎嚢を認められなかった。搬送時血中hCG値は1,384 mIU/mであった。貧血の進行と腹腔内出血の増加を認めたため、異所性妊娠を疑い腹腔鏡下手術を施行した。腹腔内を観察すると、右黄体嚢胞から持続出血を認めたため同部位を凝固止血した。左右の卵管に異常所見は認めなかった。出血量は約100 mlであった。術後、子宮内の胎嚢を認め子宮内妊娠を確認した。\n【結語】妊娠初期で血中hCG値が低い場合は、異所性妊娠を念頭に置くと同時に卵巣出血との鑑別が重要である。進行性の貧血や腹腔内出血を伴った場合は、躊躇なく緊急腹腔鏡下手術を行い診断と治療を行う必要がある。","subitem_description_type":"Other"}]},"item_3_full_name_2":{"attribute_name":"著者(ヨミ)","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"13343","nameIdentifierScheme":"WEKO"}],"names":[{"name":"マツオ, コウキ"}]},{"nameIdentifiers":[{"nameIdentifier":"13344","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ツツミ, セイジ"}]},{"nameIdentifiers":[{"nameIdentifier":"13345","nameIdentifierScheme":"WEKO"}],"names":[{"name":"ニシムラ, キョウコ"}]},{"nameIdentifiers":[{"nameIdentifier":"13346","nameIdentifierScheme":"WEKO"}],"names":[{"name":"フカセ, ミカ"}]},{"nameIdentifiers":[{"nameIdentifier":"13347","nameIdentifierScheme":"WEKO"}],"names":[{"name":"マツカワ, ジュン"}]},{"nameIdentifiers":[{"nameIdentifier":"13348","nameIdentifierScheme":"WEKO"}],"names":[{"name":"タケハラ, 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